Debonding Of Orthodontic Brackets Research Articles

Performance of two laser motion modes versus conventional orthodontic ceramic brackets debonding technique on enamel surface topography.

The risk of enamel deterioration that frequently coexists with debonding of orthodontic teeth brackets elevates the mandate for finding an optimum approach for debonding them without harmful effects. This in-vitro study is intended to compare the effects of two different laser modes (scanning and circular) and a conventional method on the enamel surface after debonding orthodontic brackets. 66 extracted premolars were assigned into 3 groups. After that, light-cure composite resin was used to attach the ceramic brackets to the teeth. Amongst the test groups, Group I: specimens that were debonded using conventional debonding using pliers; Group 2: specimens that were debonded using Er, Cr: YSGG laser applications using the circular motion method; and Group 3: specimens that were debonded using Er, Cr: YSGG laser applications using the scanning motion method. Adhesive Remnant Index (ARI) assessment, intra-pulpal temperature increase, enamel surface roughness after polishing, and assessment of the microstructure of enamel were carried out with scanning electron microscopy. The gathered information was examined statistically. The conventional debonding method had a significantly higher proportion of adhesive remnant index (ARI) scores of 2 and 3 in comparison to the circular (p < .004) and scanning laser groups (p < .001). There was no significant difference in ARI scores between the circular and scanning laser groups (p > .05). Moreover, the circular and scanning laser debonding methods resulted in a significantly higher proportion of Enamel Surface Roughness (ESR) scores of 0 and a lower proportion of ESR scores of 3 compared to the conventional technique group (p < .001). However, there was no significant difference in ESR scores between the circular and scanning laser methods (p = .945). Lastly, the average intra-pulpal temperature was significantly higher in the circular laser group (1.9 ± 0.5 ) compared to the scanning laser group (0.9 ± 0.2) with p < .001. Er, Cr: YSGG laser irradiation is a tool that shows promise for debonding ceramic brackets with minimal harm to the enamel surface. The scanning laser technique is more desirable due to the lower intra-pulpal temperature increase.

Enamel surface roughness following debonding resin clean up using high speed air-turbine and electric handpieces. In vitro study

BackgroundHigh speed electric handpieces have recently been growing in popularity among dental professionals. Advantages include smoother surface preparation and increased cutting efficiency.AimThe primary objective was to compare enamel surface roughness following resin cleanup after bracket debonding using highspeed air turbine versus electric handpiece. The secondary objective was to record the time needed for resin-clean up.MethodForty deidentified freshly extracted human premolars were cleaned and sectioned at the cement-enamel junction. The crowns were embedded in acrylic blocks. Enamel surface roughness parameters (Ra, Rz, Rp and Rv) were measured using a stylus profilometer. Brackets were bonded using a light-cure orthodontic adhesive and stored in distilled water for 24 h. Following bracket debonding, the specimens were randomly divided into 2 groups: First group: resin clean-up was carried out using a 12-fluted carbide bur mounted on a high-speed air turbine; and second group: where an electric handpiece was used. Surface roughness parameters were measured following resin clean up and after polishing using pumice and a rubber cup. Time needed for resin clean-up was recorded. Differences in enamel surface roughness and time between groups were compared using repeated measures ANOVA and independent samples t-test, respectively at P ≤ 0.05.ResultsThe electric handpiece groups showed significantly higher values for Ra, Rz and Rp both following resin cleanup and polishing. Time taken for resin cleanup was significantly longer for the electric handpiece group.ConclusionConsidering both surface roughness and time, electric handpiece do not seem to add greater effectiveness or efficiency to resin cleanup following orthodontic bracket debonding.

The Influence of Thermocycling Testing on Enamel Microcracks following the Metal Orthodontic Brackets Debonding

Enamel microcracks (EMCs) arising during the removal of metal orthodontic brackets represent a considerable challenge in dentistry. This in vitro study aims to explore the impacts of thermocycling, the types of orthodontic bonding agent, and curing techniques on the enamel surface of the tooth structure following the debonding of orthodontic metal brackets. It also examines the incidence, number, length, and direction of EMCs on the buccal surface of the tooth. Additionally, the study compares adhesive remnant index (ARI) scores and bracket failure post-debonding. Forty extracted human maxillary canines were divided into ten groups, including intact enamel negative controls (groups 1, 2) and groups (3–8) with metal brackets bonded using two different bonding agents and curing techniques. Following bonding, half of the groups underwent thermocycling testing. EMCs, ARI scores, and bracket failure modes were evaluated. The formation, length, and direction of cracks did not significantly differ among groups, regardless of experimental conditions. Thermocycling had no significant effect on ARI scores or bracket failure modes. However, significant variations were observed among curing technique groups, with seventh-generation bonding agents demonstrating potential effectiveness in achieving complete adhesive removal. The study underscores the importance of considering bonding agent systems and curing protocols to optimize bond outcomes and minimize the risk of metal bracket failure in orthodontic treatment.

Evaluation of enamel surface integrity after orthodontic bracket debonding: comparison of three different system.

This study aimed to evaluate enamel surface integrity and time consumed during residual cement removal after bracket debonding using different adhesive removal burs with and without a dental loupe. Sixty human-extracted premolars were collected, cleaned, mounted, and prepared for orthodontic bracket bonding. Teeth were randomly divided into three main groups (n = 20) based on the adhesive removal method: tungsten carbide system (TC), sof-lex discs system (SD), and diamond system (DB) groups. Then, each group was subdivided into two subgroups (naked eye and magnifying loupe subgroups). The brackets were bonded and then debonded after 24h, and the Adhesive Remnant Index (ARI) was assessed. The adhesive remnants were removed by different systems, and the final polishing was performed by Silicone OneGloss. The enamel surface roughness was evaluated before bracketing (T0), after residual cement removal (T1), and finally after polishing (T2) using surface Mitutoyo SJ-210 profilometry and Scanning Electron Microscopy (SEM) to determine the Enamel Damage Index (EDI) score. The time consumed for adhesive removal was recorded in seconds. The Kruskal Wallis test showed a statistically significant difference in roughness values at T1 compared to T2 between subgroups (p < 0.001). When comparing EDI at T1 and T2, the Kruskal-Wallis H-test showed statistically significant differences in all subgroups. The pairwise comparisons revealed that EDI scores showed a statistically significant difference at T1 and T2 between DB vs. TC and SD (p = 0.015) but not between TC vs. SD (p = 1.000), indicating the highest roughness value observed in the DB group. The time for cement removal was significantly shorter in the magnifying loupe group than in the naked eye group and was shortest with the TC group, whereas the time was the longest with the DB group (p < 0.05). All three systems were clinically satisfactory for residual orthodontic adhesive removal. However, TC system produced the lowest enamel roughness, while the DB system created the greatest. The polishing step created smoother surfaces regardless of the systems used for resin removal.

Comparison of Enamel Surface Roughness after Orthodontic Brackets Debonding and Surface Polishing with Restorative and Orthodontic Composites

Introduction: Emergence of superficial enamel roughness following orthodontic bracket debonding leads to the accumulation of microbial plaque, resulting in the development of dental caries and compromising the aesthetics and health of the tooth enamel. The objective of this current study is to investigate the Enamel Surface Roughness after Orthodontic Brackets Debonding and Surface Polishing with Restorative and Orthodontic Composites. Materials and Methods: In the present study, three types of composites were used for bonding metal orthodontic brackets. The samples were randomly divided into three cure groups: XT, GC, and SHOFU. Subsequently, the brackets were debonded, and the target surfaces were treated using a carbide bur for one minute by an operator to remove adhesive remnants and be prepared for bonding. The superficial enamel roughness was then examined. Furthermore, the samples were evaluated for the Adhesive Remnant Index before and after adhesive removal and enamel surface preparation. The data were analyzed using ANOVA test and SPSS software version 22. Results: The results indicated that there was no significant difference in surface roughness among the tested groups. However, a significant difference was observed between the surface roughness of the experimental groups and the healthy enamel surface (P&lt;0.05). Moreover, among the different experimental groups, there were statistically significant differences in the Adhesive Remnant Index (ARI) after bracket debonding, before and after enamel surface cleaning. These differences were primarily due to distinctions between the XT and SHOFU groups, as well as between the GC and SHOFU groups. However, there was no significant difference in ARI before and after enamel surface cleaning between the XT and GC groups (P&gt;0.05). Conclusion: The results of the present study indicate a desirable and acceptable performance of the composite material. It is suggested that future studies focus on a comparative investigation of several cleaning and surface preparation systems.

Effect of Different Chemical Solvents on Bond Strength of Orthodontic Brackets: An In Vitro Study.

The purpose of the present study was to evaluate the impact of various chemical solvents on bond strength of orthodontic brackets. One hundred healthy human premolars with undamaged buccal surfaces that were extracted for orthodontic purposes were gathered. Using 37% orthophosphoric acid, primer, and Transbond XT adhesive, ceramic 0.018" × 0.022" slot orthodontic brackets were adhered to the tooth surface. Following thermocycling, all samples were divided into four groups, with 25 samples in each group: group I: control; group II: application of ethanol; group III: application of acetone; and group IV: application of dimethyl sulfoxide (DMSO). Following the debonding tests, a double-ocular stereomicroscope was used to inspect the tooth surfaces. Additionally, adhesive remnant index (ARI) values were evaluated at 40× magnification. Data were recorded and statistically analyzed. The bond strength was lesser in acetone applied group (16.18 ± 3.64) followed by DMSO applied group (22.08 ± 2.86), ethanol applied group (24.36 ± 4.02), and control group (27.14 ± 3.68). There was a highly significant difference found between the chemical solvents group. The ARI score 3 was present in control (12%), ethanol (8%), and DMSO (4%), and it was absent in acetone applied group. The ARI score 0 was more in acetone applied group (24%). The present study concluded that the reduced debonding force was found with the application of acetone solvent followed by DMSO, ethanol, and control groups. Applying acetone can be a substitute technique to help with ceramic bracket debonding. Orthodontic bracket debonding cannot occur without shear bond strength (SBS). The need for an ideal debonding technique for ceramic brackets without negative consequences arises from the risk of enamel damage that frequently follows the process. Acetone treatment prior to ceramic bracket debonding could be an alternate clinical technique to preventing enamel damage and facilitating debonding. How to cite this article: Bhushan R, Singh S, Sam G, et al. Effect of Different Chemical Solvents on Bond Strength of Orthodontic Brackets: An In Vitro Study. J Contemp Dent Pract 2023;24(12):940-943.

An In-Vitro Analysis of the Surface Treatment of Orthodontic Bracket Bases With Er,Cr:YSGG Laser and Its Effect on Shear Bond Strength.

Introduction Shear bond strength is indispensable to prevent the debonding of orthodontic brackets. Lasers have been proven to alter the bond strength of orthodontic brackets, but their efficiency has not been validated in many trials. The study aimed to evaluate the impact of the Er,Cr:YSGG laser on the bases of orthodontic brackets and determine their bond strength with the enamel surface. Materials and methods The Waterlase iPlus (made in the USA in 2012), comprising an Er,Cr:YSGG laser, was used. Based on the surface treatment of brackets, two groups were assigned (n=10), comprising laser-treated and untreated bracket bases. The brackets were treated with the minimum laser intensity (50 Hz, 4.5 W). Then, the brackets of both groups were attached to the labial surfaces of previously extracted premolars, respectively. The shear bond strength of brackets (SBS) was assessed using the universal testing device, and the Adhesive Remnant Index (ARI) was also measured. An independent sample t-test was used to compare the bond strength between the laser-treated and untreated brackets. Results The mean bond strength of laser-treated and control group brackets was 5 MPa and 8.63 MPa, respectively. The laser-treated brackets showed lower bond strength than the control brackets, but the results were statistically insignificant (p=0.23). The ARI analysis stated that bond failures occurred mostly in the region of the bracket and adhesive interface. Conclusion Laser-etched bracket bases showed lesser shear bond strength than the untreated ones, though the difference was statistically insignificant.

The Influence of Various Adhesive Systems and Polishing Methods on Enamel Surface Roughness after Debonding of Orthodontic Brackets: A Three-Dimensional In Vitro Evaluation.

A slight alteration of the enamel surface is inevitable upon debonding of orthodontic brackets, adhesive removal, and finishing/polishing. The aim of this in vitro study was to compare two adhesives and three polishing methods by measuring enamel surface roughness using confocal laser scanning microscopy (CLSM). Brackets were bonded on 42 extracted human premolars using Transbond XT (Transbond group) or Fuji Ortho (Fuji group). After debracketing, adhesives were removed with a tungsten carbide bur, and surfaces were polished using Sof-Lex discs, a rotary brush with a prophylactic paste (Depural), or a prophylactic cup with two polishing pastes (n = 7 in each subgroup). Surface roughness (Sa, Sku, Sq, and Sz) was measured using CLSM and compared before treatment (T1), after debracketing and adhesive removal (T2), and after polishing (T3). The data were statistically analyzed using the Mann-Whitney U and Kruskal-Wallis tests with Bonferroni correction. The time required for adhesive removal was measured and compared using a two-sample t-test. Surface roughness at T2 increased compared to T1, but the difference was significant only for the Fuji group (p < 0.01). The time required to remove Transbond XT (94.1 ± 6.8 s) was significantly higher compared to Fuji (72.1 ± 5.9 s, p < 0.0001). Polishing with Sof-Lex discs resulted in lower surface roughness compared to T1 (p = 0.018). Using Depural and polishing pastes showed no significant difference in surface roughness compared to T1, except for a significant decrease in Sa and Sq for Transbond (p = 0.043) and in Sku for Fuji (p = 0.018) after polishing with Depural. In conclusion, the removal of Transbond took significantly longer, but there were fewer residues of composite resin on the enamel surface. Sof-Lex discs decreased enamel roughness, whereas enamel morphology and roughness were similar to the pre-treatment state after polishing with polishing pastes.

Effectiveness of Porcelain Polishing Methods on the Roughness and Color Stability of CAD-CAM Ceramics after Orthodontic Bracket Debonding.

Increased utilization of all ceramic restorations for aesthetic consideration in combination with routine adult orthodontic practice has led to numerous clinical challenges. Obtaining adequate bond strength between the orthodontic bracket and all-ceramic restoration and damage to the ceramic surface during the bracket debonding procedure needs to be better understood. This study analyzed the surface texture and color change of glazed and bracket-debonded ceramic CAD-CAM materials and the efficiency of porcelain polishing systems in restoring surface morphology and color. A total of 30 rectangular test specimens from each lithium disilicate CAD (LD-CAD), polymer-infiltrated ceramic (PICN), zirconia-reinforced lithium silicate glass ceramic (ZLS), and 5YTZP zirconia (5YZP) were prepared. The ceramic samples were embedded within acrylic resin, and baseline surface roughness and color were recorded using an optical profilometer and a reflected color spectrophotometer. The porcelain samples were bonded with lower incisor ceramic brackets. The samples were thermocycled 2000 times between 5 and 55 °C. Afterward, the brackets were peeled with bracket-removing pliers. The resin adhesive from the debonded surface was eliminated with tungsten carbide bur, and samples were randomly divided into three subgroups of (n = 10) to be polished with Diapol-twist (DT), a Keramik-Politur 4313B Komet polishing kit (KK), and a Horico diamond polisher (HDP). The polished surface roughness and color were recorded. The data were statistically analyzed using a two-way analysis of variance at p < 0.05. The debonded porcelain surfaces across the groups displayed significantly higher mean surface roughness (Ra) compared to glazed surfaces. The debonded 5YZP showed the least Ra at 0.661 (0.09), while the highest Ra was recorded by PICN at 4.057 (0.82). All of the polishing systems evaluated in the study significantly reduced the surface roughness. However, they were unsuccessful in regaining the surface topography of the glazed surface. The flexible discs (DT) produced the smoothest surface, followed by the diamond-impregnated rubber points (KK). Unpolished porcelain surfaces had a discernable mean color difference from glazed surfaces. Polished surfaces from the different polishing systems among the all-ceramic groups achieved a clinically acceptable mean color difference. Polishing debonded rough porcelain surfaces is imperative, and flexible discs performed better in all of the tested CAD-CAM ceramic materials.

Comparison Of Different Methods Of Controlling Pain During Debonding Of Orthodontic Brackets.

To compare the efficacy of finger pressure and plastic wafers in terms of pain control during debonding. This cross sectional study was conducted at the Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to June 2020, and comprised patients of either gender aged 13-21 years who had completed fixed orthodontic treatment with 0.022 brackets of Roth prescription and required debonding. The patients was divided into two equal groups. In group A, teeth were stabilised with finger pressure with cotton between the finger and teeth, and then debonding was done using open mouth technique. In group B, teeth were stabilised using a plastic wafer between maxillary and mandibular teeth, and then debonding was done using closed mouth technique. Pain was assessed using a visual analogue scale VAS. Data was analysed using SPSS 23. Of the 110 patients, each of the 2 groups had 55(50%) subjects. Overall, there were 35(32%) males and 75(68%) females. The mean age of the sample was 16±2.4 years. Mean pain scores among the males was 32.0±7.68 compared to 34.067±12.59 among the females (p>0.05). Subjects in group B had significantly less pain than those in group A (p<0.05). Plastic wafer was found to be more effective in terms of controlling pain during debonding compared to finger pressure.

Effectiveness of surface polishing after debonding of metal brackets from different CAD-CAM materials.

The purposes of this study were to compare and evaluate the surface texture of different restorative computer-aided design and computer-aided manufacturing (CAD/CAM) materials before bonding and after debonding of metal orthodontic brackets. Atotal of 60rectangular ceramic test specimens (n = 20 in each group) were prepared using feldspathic ceramic blocks (FLD; served as control), hybrid ceramic blocks (HC), and lithium disilicate ceramic blocks (LDC). Surface roughness (Ra) analysis was conducted using aprofilometer before bonding the metal brackets. After the debonding and polishing procedures, asecond surface roughness analysis was conducted on each specimen. The shear bond strength (SBS) test was applied to each specimen using auniversal test machine for debonding the metal brackets. The debonded specimens were examined under astereomicroscope and scored using a4-step adhesive remnant index (ARI). The Ra and SBS values and the ARI scores were saved, and the data were analyzed statistically at asignificance level of 0.05. One specimen from each group was examined under atomic force microscopy to visualize surface roughness. Furthermore, one specimen from each group was additionally prepared for scanning electron microscopy analysis. Statistically significant differences in SBS measurements were observed between all three groups. The highest SBS values were obtained from the FLD group, the lowest from the LDC group. The HC group showed significantly (P = 0.001) lower Ra values than the LDC and FLD groups after debonding and polishing. No significant differences were observed in the ARI scores between the groups. Hybrid ceramics could be asuitable alternative for fixed restorations in adult patients receiving subsequent treatments with fixed orthodontic appliances.

Effect Of Er, Cr: YSGG And Er: YAG Lasers During Debonding Of Orthodontic Ceramic Brackets: In Vitro Study

Effect Of Er, Cr: YSGG And Er: YAG Lasers During Debonding Of Orthodontic Ceramic Brackets: In Vitro Study

Efficacy of Bracket Adhesive Remnant Removal by a Fluorescence-Aided Identification Technique with a UV Light Handpiece: In Vitro Study.

Objective This study aims to analyze the fluorescence-aided identification technique efficacy on adhesive remnant removal from the enamel surface after orthodontic bracket debonding. Materials and Methods Forty-five extracted human upper central incisors were divided into 3 groups (n = 15) according to the kind of adhesive for bracket bonding and the use or absence of near UV light for remnant removal: BF/UV- fluorescent adhesive/UV light, BF/0-fluorescent adhesive/no UV light, and TB/0-nonfluorescent adhesive/no UV light. For all teeth, 100% of the adhesive used remained on the enamel surface after debonding. Fifteen dentists performed adhesive removal on the enamel surface using a carbide bur. The specimens were analyzed by a stereomicroscope, and the adhesive remnant percentage from each specimen was calculated. The time used by each dentist to perform the removal was recorded. The data were analyzed by one-way ANOVA and Tukey's test. Results Significant differences were observed among groups for adhesive remnant (p=0.0008) and for time (p=0.0001). The means of adhesive remnant were BF/UV (5.84), BF/0 (34.37), and TB/0 (37.02). The mean times necessary to remove adhesive were BF/UV (1 min 40 s), BF/0 (3 min 03 s), and TB/0 (2 min 46 s). For the BF/UV group, significantly lower values of adhesive remnants and time for debonding were found (p < 0.05). Conclusion The fluorescence-aided identification technique significantly reduced the amount of adhesive remnant, and the time necessary to perform this clinical procedure.

Comparative effects of tungsten, diamond burs and laser for residual adhesive removal after orthodontic debonding on flexural strength, surface roughness and phase transformation of high-translucent zirconia: An in vitro study

ObjectivesInformation regarding the effects of orthodontic bracket debonding on zirconia restorations, and the preferred method for residual adhesive removal from the zirconia restoration surface is lacking. Thus, this study aimed to assess the effects of different methods of residual adhesive removal after orthodontic bracket debonding on flexural strength, surface roughness, and phase transformation of high-translucent (HT) zirconia. Materials and methodsThis in vitro study evaluated 72 bar-shaped HT zirconia specimens; 18 specimens were assigned to the control group. Metal brackets were bonded to the remaining specimens by resin cement. After bracket debonding, the residual adhesive on the surface of specimens was removed by three methods (n=18): a 30-flute tungsten-carbide (TC) bur at low speed, an ultrafine diamond bur at high speed, and Er:YAG laser irradiation. The surface roughness (Ra and Rz) was measured. X-ray diffraction (XRD) analysis was carried out, and the flexural strength was measured as well. Data were statistically analyzed (α=0.05). ResultsBefore polishing, all methods increased the Ra and Rz values (P<0.05) except for the diamond bur yielding a Rz value comparable to that of the control group. The Ra values of the test groups were comparable after polishing, and still higher than that of the control group (P<0.05). The flexural strength of all three test groups was comparable (P>0.05), and significantly lower than that of the control group (P<0.001). The monoclinic phase was not observed in any group. ConclusionsOrthodontic bracket debonding adversely affects the surface roughness and flexural strength of zirconia despite polishing.

Comparative evaluation of three methods of adhesive remnant removal after orthodontic bracket debonding.

This study aimed to assess the effects of three methods of adhesive remnant removal (carbide bur and low speed handpiece, carbide bur and high speed handpiece, and zircon-rich glass fiber reinforced composite bur), after orthodontic bracket debonding, on tooth color and enamel surface roughness. Ninety sound premolar teeth were selected. The baseline tooth color was assessed using Vita spectrophotometer. The teeth were subjected to bracket bonding processes and then randomly divided into three equal groups. In each group, composite remnant was removed by one of the three methods of adhesive removal, and the teeth were then subjected to color assessment again. To measure the surface roughness, a scanning electron microscope (SEM) with x400 magnification was used. ANOVA showed that the effect of the three methods of adhesive remnant removal on ∆L, ∆b and ∆E was statistically significant (p=0.01), but without significant effect on ∆a. Comparison of the means showed that composite bur and high speed carbide bur yielded the highest ∆E (p=0.05), and had a significant difference when compared to carbide bur and low speed handpiece. The highest ∆L and ∆b values belonged to samples approached with composite bur and carbide bur with high speed handpiece, respectively. SEM analysis showed that the composite bur created a very smooth surface, compared to the other two methods. Zircon-rich glass fiber reinforced composite created the smoothest enamel surface and highest color change, when compared to the other two methods.

The influence of Nd: YAG pulsed laser treatment on the structure, morphology and hardness of e.max ceram dental material

The use of ceramics in dentistry is increasing day by day owing to their more aesthetic look, better mechanical properties, and easy-to-fit approach. The material used in the study is IPS e.max Ceram by Ivoclar Vivadent which has been widely adopted as the ceramic of choice by many dentists as it is ideally suitable for the veneering of more opaque substructures. The study aims to elucidate the result of Nd: YAG pulsed laser irradiation at different numbers of pulses on structure, surface morphology, and hardness of e.max Ceram dental material. XRD shows the amorphous nature of the material before the laser irradiation, whereas the crystallinity in the material is slightly induced after the exposure of e.max Ceram with 150 laser shots. The surface morphology and hardness degradation are attributed to the swelling potential of the material and induced increase of the residual micro-stresses during laser irradiation. This technique could provide more ease for bonding and de-bonding of orthodontic brackets and might be used as a chairside tool.

What are the risk factors specific to patient for debonding of orthodontic brackets?

The premature detachment of orthodontic brackets has consequences for the patient and the practitioner. While the responsibility for the bonding protocol has been widely assessed, the responsibility of the patient is poorly understood. The main objective of the study was to look for patient-specific predictors of metal vestibular attachment detachments. An historical cohort study was carried out from adolescents having benefited from a fixed vestibular appliance treatment lasting 27months +/- 3months, having all teeth from first molar to first molar on arch to pose. Univariate and multivariate analyses were performed by logistic regression. 333patients were included. In univariate analysis, boys tended to take off more than girls, patients in skeletal Class II more than those in Class I, those with at least two cooperative remarks more than those with less than two remarks. The percentage of patients with debonding increases with the number of hygiene remarks. Younger patients were more prone to debond than older patients. The "age" factor has a significant effect in multivariate analysis. Neither the vertical skeletal pattern nor the socio-economic level would intervene in the rate of debonding. The role of patient-specific factors in detachment should be put into perspective. The reliability of the results would be increased by a prospective study using validated indicators of compliance.

Residual Adhesive Removal Methods for Rebonding of Debonded Orthodontic Metal Brackets: Systematic Review and Meta-Analysis.

Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated. This study aimed to evaluate the bond strength of rebonded brackets after different residual adhesive removal methods. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, The Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Bond strength comparisons were made considering the method used for removing the residual adhesive on the bracket base. A total of 12 studies were included for the meta-analysis. Four different adhesive removal methods were identified: sandblasting, laser, mechanical grinding, and direct flame. When compared with new orthodontic metallic brackets, bond strength of debonded brackets after air abrasion (p = 0.006), mechanical grinding (p = 0.007), and direct flame (p < 0.001) was significantly lower. The use of an erbium-doped yttrium aluminum garnet (Er:YAG) laser showed similar shear bond strength (SBS) values when compared with those of new orthodontic brackets (p = 0.71). The Er:YAG laser could be considered an optimal method for promoting the bond of debonded orthodontic brackets. Direct flame, mechanical grinding, or sandblasting are also suitable, obtaining clinically acceptable bond strength values.

Evaluation of enamel surface roughness using different types of polishing system after orthodontic bracket debonding

Background: returning surface of the enamel to its pre-orthodontic state after debonding of brackets without any damage to the texture of enamel is a clinical contest. removal of Residual adhesive using correct and suitable tools and methods ensures a smooth surface and healthy plaque-free environment. Therefore; the study aims to determine the safest method to finish enamel surface after bracket debonding using three different methods. Method: Thirty premolars extracted for orthodontic purposes were selected for this study. The samples were coded 1-30 randomly and surface roughness was measured before bracket placement using profilometer. Then bracket bonded in the middle third of the buccal surface of the premolars and then debonded using debonding plier. The sample was divided into three groups, 10 for each group (group 1: 18-flute tungsten carbide bur, group 2: 12- flute tungsten carbide bur, group 3: adhesive removing plier). Then the second roughness measurement was recorded. Result: It is found that debonding with adhesive removing plier was the least efficient method followed by 12-fluted tungsten carbide bur, so the best clean-up method in this study achieved is by using 18-fluted tungsten carbide bur. Conclusion: The 18-fluted flame-shaped tungsten carbide bur at high speed for orthodontic adhesive removal demonstrated more favorable results in our hands, as it resulted in the smoothest enamel surface and could reasonably be used as a standard by which future other burs or other procedures are compared.

The Effect of Er:YAG Lasers on the Reduction of Aerosol Formation for Dental Workers.

Infection prevention in dental practice plays a major role, especially during the COVID-19 pandemic. This study aimed to measure the quantity of aerosol released during various dental procedures (caries and prosthetic treatment, debonding of orthodontic brackets, root canal irrigation) while employing the Er:YAG lasers combined with a high-volume evacuator, HVE or salivary ejector, SE. The mandibular second premolar was extracted due to standard orthodontic therapy and placed in a dental manikin, to simulate typical treatment conditions. The particle counter was used to measure the aerosol particles (0.3–10.0 μm) at three different sites: dental manikin and operator’s and assistant’s mouth area. The study results showed that caries’ treatment and dental crown removal with a high-speed handpiece and the use of the SE generated the highest aerosol quantity at each measured site. All three tested Er:YAG lasers significantly reduced the number of aerosol particles during caries’ treatment and ceramic crown debonding compared the conventional handpieces, p < 0.05. Furthermore, the Er:YAG lasers generated less aerosol during orthodontic bracket debonding and root canal irrigation in contrast to the initial aerosol quantity measured in the dental office. The use of the Er:YAG lasers during dental treatments significantly generates less aerosol in the dental office setting, which reduces the risk of transmission of viruses or bacteria.